The deadly plot unrealized. The heart attack not had. The truth is that the successes of both national security and public health often pass by unnoticed. Failures are tallied in fatalities. But assessing the social value of programs by counting the number of people who do not die, such as people saved by detecting a bomb or by new food labeling laws, can make effectiveness tough to measure.
The matter is further obscured by the nature of the threats they aim to fend off. Especially since the 9/11 attacks, security threats often loom larger in the collective national consciousness than health threats, although the chances of dying in a plane crash (of any kind), for instance, is about one in 20,000, whereas the odds of dying from a stroke are about one in 23—with the bulk of strokes likely being preventable. Disparate odds of this order are true of most security versus health risks.
So, how is the federal government spending money to stave off deaths from bombings and bugs alike? And does that spending reflect the relative risks of health threats versus security threats? Here is a glance at the budgets of the U.S. Department of Homeland Security (DHS), which is charged with terrorism prevention, cyber security and immigration enforcement, among other things, and the U.S. Centers for Disease Control and Prevention (CDC), which helps to fight infectious and chronic diseases, prevent injury and improve other health areas.
For the 2012 fiscal year, the DHS requested $57 billion in funding from the federal government, promising to have cut more than $800 million from administrative inefficiencies (which they plan to divert to "strengthen mission critical activities," according to the department's budget overview). The CDC requested $11.3 billion for 2012, and said that it includes some $100 million trimmed from administrative costs. (The CDC is part of the Department of Health and Human services, which also runs Medicare and Medicaid, as well as the Food and Drug Administration, the National Institutes of Health and other wellness-related programs; it requested $892 billion for its 2012 budget.)
Given the greatly different natures of the two fields—security and preventive health—in how they report data and their goals, it is difficult to devise a measure of their comparative efficacy. By many counts, preventive health funds are cited as paying off some five times in saved medical costs per every dollar invested, whereas, a similar savings multiplier is not advanced regarding security funds. Likewise, it is also challenging to estimate the dollars per life saved for the various approaches to security and preventive health.
For one pair of researchers, however, the algebra is actually quite clear. For the more than $1 trillion the U.S. has spent on domestic security in the past decade to be justified in terms of lives saved, counterterrorism efforts would need to "have successfully deterred, derailed, disrupted, or protected against attacks that would otherwise have resulted in the deaths of more than 3,000 people in the country every year, equivalent to experiencing attacks as devastating as those on 9/11 at least once a year or 18 Oklahoma City bombings every year," the researchers wrote in the August issue of Homeland Security Affairs.
"Even if all of the terrorist plots exposed since 9/11 in the United States had been successfully carried out, their likely consequences would have been much lower," John Mueller, chair of National Security Studies at Ohio State University, and Mark Stewart, director of the Center for Infrastructure Performance and Reliability at The University of Newcastle in Australia, noted in their analysis. Although much security work is secretive, thus some thwarted attacks might remain undisclosed, based on public information, the "enhanced expenditures have been excessive…[even though] there are emotional and political pressures on the terrorism issue," they concluded.
The relative levels of security versus health spending on preventable deaths might however, make sense from a psychological perspective. Researchers who study risk perception have found that people tend to assess risk to themselves differently than they do risks to the broader population—even when they know the hard, relative numbers. "Riskiness is based on perception rather fact," Clinton Jenkin, a researcher at the University of New Hampshire, wrote in a 2006 paper published in Homeland Security Affairs.
So although the money spent on different prevention methods might not map out onto the available data, it might show more where our own—culture-driven or innate—fears lie. A lifetime of exposure to unhealthy foods or low levels of exercise has perhaps dulled the dread of a losing battle with heart disease (the leading cause of death in the U.S.), but lingering anxieties about a one-in-a-million-type terrorist attack keep funds—and, as no small consolation, jobs—flowing more freely to domestic security. And who is to say that that extra $1 million for domestic security is not going to supply the extra eyes—or canine nose—that detects the next nefarious plot? The research has already shown what that money would do in a preventive health setting, so perhaps the unknown in the terrorist equation has fueled a fire of uncertainty that keeps those funds flowing.
Interactive by Krista Fuentes
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11 Comments
Add Commentso what? is this the year the CDC actually accomplishes something with its money? If national security does its job correctly, we will never know about it. If the CDC does its job right, well how can we tell. Less fat people, nope. Fewer people not wearing seatbelts? Less cellphone, eating, makeup applications while driving? Americans aren't getting any more healthy, end of story. The WTC saw two attacks, if the first response in 93 by Clinton had some teeth, there may not have been a second in 2001. So the argument that the absence of bad (terrorism) means that no good is being done, while evidence of really bad (poor health) means we are doing good cuz it could be lots worse?
Reply | Report Abuse | Link to thisThe irony of spending ever more on "security" both at home and through militarism abroad is that doing so often makes us less safe - not just from foreign hostiles, but from our own government as well.
Reply | Report Abuse | Link to thisHmmm, if a catastrophe happens, such agencies tell us "Gimme more (money/power), because then we can prevent it all." and if nothing happens, why, they'll simply tell us "See, we're doing good, just keep giving". Where's the transparency? Are we dealing with a financial black hole or is it actually working? Who can tell?
Reply | Report Abuse | Link to thisMe, I'm quite willing to live with a certain measure of insecurity. After all, you want to have maximum security? Go lie in a grave. Or move to North Korea.
Ahhh...the old, flawed, ignorant and stupid "Clinton did nothing after the '93 attack". Let's revisit such ignorance with the help of Snopes.com:
Reply | Report Abuse | Link to thishttp://www.snopes.com/rumors/clinton.asp
We should also mentioned that Clinton also submitted legislation to Congress that would have tightened security of air transport (including such nuances as putting locks on the cockpit doors which would have prevented or at least made 9/11 a lot more difficult). It was voted down by the airline-backed Republicans under the pretense that it would...as they always cry...be a "job killer".
He then submitted legislation requesting tracing agents be put into commercially available explosive components. Voted down by NRA-backed Republicans in Congress.
But, hey...let's keep voting for the Republicans because THEY have your best interests at heart. After all, after 9/11, what did Bush do? He attacked the wrong country. Well done!
Get a clue, dimwit. If we ever implement intelligence tests to vote, we'll finally be rid of the kind of people you'd elect.
BTW, on the whole Americans ARE getting more healthy...to a degree. The decline in health is more closely correlated to the sharp decline in availability of health care to every citizen.
"although the chances of dying in a plane crash (of any kind), for instance, is about one in 20,000"
Reply | Report Abuse | Link to thisThis jumped out at me. If the odds were truly that bad , people would be dying from plane crashes almost constantly, given that presumably 100's of thousands or millions of people fly each day. From what I've found, the risk of dying in a plane crash for an "average" American is about 1:11,000,000 (this includes non-flyers). 1 in 20,000 is probably more like the odds of a frequent flyer (lifetime risk, which then makes 1 in 20k seem low).
In any case, back to the topic, the government should probably divert a few billion from the DHS to the CDC, even with the psychological "benefits" of being felt-up by a DHS worker. I think the CDC can get guaranteed better results, while the DHS only "might" stop an attack...especially given the primary focus on making air-travel safe.
Maybe they should bulk up the funding for FEMA as well. When you're talking about giving $57B per year to DHS, would it really be that expensive to outfit 3 or 4 hurricane response teams spread out evenly over the East and Gulf coasts. Set each of them up with a few dozen low-draft boats ("Bass" boat style), 2 to 3 boat transport freight trucks, 1 or 2 fuel tankers, and plenty of emergency food and water? That probably wouldn't cost more than a $3-5 million per response team in one-time capital expenditure plus some maintenance costs (baseline staff, repairs). What happened to the victims of hurricane Katrina should NEVER happen to another American again. There should be a couple dozen rescue boats and lots of supplies en route 24 hours before a hurricane even makes landfall. Unused rescue boats and supplies (basically just wasted gasoline) for a hurricane that wasn't as bad as expected is the kind of government waste that everyone can agree on.
Hi Spoonman, I think yours is an excellent post and very informative. Thank you!
Reply | Report Abuse | Link to thiscost worthyness depends upon necessity of requirements.spending huge amount of money in billions can be justified if requirements are met for saving and nourishment of citizens lives.If demands are huge then amounts needed to be spent should be more.
Reply | Report Abuse | Link to this@jbairddom both the CDC and the DHS have the same problem you describe - how to account for magnitude of the effects of prevention. If something didn't happen, how can you say how big it would have been?
Reply | Report Abuse | Link to thisIf you want to compare potential outcomes you can pick from history and show that a 9/11 may have killed up to 5,000 people if you factor in medium-term health outcomes, and against that we can compare an influenza epidemic which in the US killed around 500,000 in the 1918 outbreak.
SARS had the potential for a similar outcome, and was effectively prevented by CDC activities, and we could ask how many 9/11's DHS would need to prevent in order to match a fullblown SARS epidemic in the US.
However, the article doesn't go there, it describes instead the relative spending and how many 9/11 incidents each of the two would need to have prevented to justify the money spent.
If you want to see mortality tables for the US, try WISQARS at http://webappa.cdc.gov/sasweb/ncipc/leadcaus10.html
You can then measure various causes of death in the US in terms of how many 9/11's they equate to and therefore how much money one might want to spend on prevention.
Cost benefit analysis is difficult in these situations.
Reply | Report Abuse | Link to thisBUT, a point in the article did mention the returns on health investment being returned 5-fold.
That is not suprising since it is a FACT that INVESTMENT INTO INFRASTRUCTURE yields returns of 3-fold or more (like bridges, roads, etc.). People are infrastructure. The health and education of Americans is very important. It is a good investment, if I had the time I'd link some articles.
Of course, so is our safety. But you can never be perfectly safe, especially since politicians of America with the CIA's help caused the Taliban to come into existence (we basically funded its develoment). And thus we shoudl question how much do we spend on homeland security and whether or not it is worth it. Heck, Gov. McGreevey appointed his foreign gay lover to the top homeland security position in New Jersey. That really doesn't endose that this kind of agency and funding is doing anything at all. And if it turns out that this security is as cost effective as the Texas border fence... well, that would just mean friends of the politicians are simply getting rich (yet again) off of hard working Americans. Important, yes, but it better be cost effective because I can think of many ways to improve our security such as simply putting more policemen on the streets and giving air traffic controllers longer breaks and better hours.
Cut DHS funding to programs in flyover country. Nobody overseas cares about red states -- it's New York, Washington and California that are symbols of freedom and "America", and are repeatedly targeted.
Reply | Report Abuse | Link to thisKind of ironic, ain't it?
In the 10 years since 9/11 , according to government data-National Vital Statistics Reports, there have been over 24,000,000 deaths in America. We average each year about 40,000 auto deaths 17,000 homicides, 590,000 deaths from heart disease, 560,000 cancer related deaths and the list goes on. Many of these deaths are preventable, but for many Americans, on both sides of the political divide this appears to be an acceptable way of life. Yes 9/11 was terrible and terrorism must be addressed, but what about the almost 2.5 million American citizens that die every year. As POGO once said..."We have met the enemy and he is us."
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